How do I get SAG or AFTRA health insurance?

Answer: One of the most valued benefits to belonging to the Screen Actors Guild (SAG) or the American Federation of Television and Radio Artists (AFTRA) is the opportunity to get great, inexpensive health insurance. How you get that insurance… (continued in David’s answer below)

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Answer: One of the most valued benefits to belonging to the Screen Actors Guild (SAG) or the American Federation of Television and Radio Artists (AFTRA) is the opportunity to get great, inexpensive health insurance. How you get that insurance is both straightforward and potentially very difficult – you need to get a minimum amount of paid acting work.

Getting health insurance is a milestone in your path to acting success. To qualify for health insurance means you’ve been cast in paid acting work to the tune of over $10,000 in a single year. And if you’re an actor that manages to make over $28,000 in paid acting work, you get even better insurance. The problem? Getting that much work in any single union’s productions.

Please know that what I’m about to share with you pains me to no end, as I am a member in good standing of both SAG and AFTRA. And know that I can’t wait to edit this post when the requirements listed here change for the better.

A bit of background: before the 2009 pilot season, almost every major primetime television show on the big networks was produced under a SAG contract. THere were AFTRA shows here and there, but almost all were SAG shows. Then, during the contract negotiations for the new TV Theatrical agreement that year, a rift occurred between the leadership of SAG and AFTRA. SAG hardliners in control of the Guild’s negotiations refused to accept a contract offer from the other side (which they eventually accepted 11 months later), an offer that AFTRA was willing to accept. For the first time in years, SAG and AFTRA were now negotiating separately, and AFTRA signed that contract. SAG did not.

For the next 11 months, the only contract available to television producers for new shows was the AFTRA contract. Almost every new show, some 70 or so, went AFTRA. Health insurance contributions, as well as pension and health contributions, were now split among the two unions, making it harder to qualify with either one. You might work on half again to twice as many shows and still not make the minimum in either.

Hopefully, with the returning to normalcy in relations between SAG and AFTRA, and an eventual merger between the two unions, this situation won’t be permanent. But, for the time being, you are facing a more difficult task than ever to qualify for one or both of the unions’ health plans.

Let’s look at SAG first. There are two plans you can qualify for, Plan I and Plan II. Once you do, you are covered under the plan for a full calendar year, as long as you pay your premiums on time.

Plan I requires that you earn $29,250 from SAG productions during what’s called your “base earning period” – one 12 month period. If you qualify for Plan I, you’ll pay $249 per quarter in premiums, whether covering you by yourself, or your immediate family. Your coverage includes hospital, major medical, dental, vision and prescription drugs, as well as mental health and chemical dependency treatment

Plan II is a bit more complicated, has a lower earnings requirement, but offers less benefits. It requires that you earn $14,350 in your base earning period, or, work 74 days in that year. If you’re 40 or over, and you’ve qualified for insurance for the last 10 years, you only have to earn $10,400 – that’s called the “age and service” Guild member. Your premiums are higher with Plan II: you’ll pay $294 per quarter, or $375 under the age and service plan. Your benefits are different as well – you don’t get dental or vision, and your deductibles are higher than Plan I.

Obviously, your goal is to qualify for Plan I. You can read all about the requirements and plan particulars at http://www.sagph.org/html/bthw3.htm on the SAG Producer’s Health Plan website.

AFTRA’s health plans are a bit different. With SAG, one premium and one qualification amount covers you individually and your family if you have one. With AFTRA, you’re only covered individually should you meet a $10,000 minimum earning threshold. If you earn that, you’re covered, but your family is not. Want family coverage? You have to earn $30,000 in the earnings period – any four consecutive quarters or less.

It gets a bit confusing when you earn $10,000 in one quarter but not $30,000, as you can’t bring your family on to the plan should you earn more the next quarter. Here’s how AFTRA’s site puts it: “…performers who meet the $10,000 threshold for Individual Health Plan qualification in a given quarter during their initial earnings cycle, but do not satisfy the $30,000 threshold for Family Health Plan qualification before that same calendar quarter ends, will only be allowed to pay the required premium and enroll in the Individual Health Plan for their first four quarter coverage period.”

Both SAG and AFTRA have lots of variations on their health care theme. Both have exceptions and options if you are a senior citizen, and both define what that means differently. Both have self-pay and optional plans should you not qualify after a year’s coverage. Both have different coverage amounts, different deductibles and different plan administrators. You’ll want to check with both unions’ web sites on a regular basis to stay on top of changes made in any of your plans.

Thank you so much for this informative article. I’ve been in the business for many years and still have a tough time keeping all the union stuff straight.

I’m currently self-paying with assistance on the SAG health plan, but just qualified for the AFTRA plan for my family and myself. Do you know of any place I can find a point-by-point comparison of benefits?